Provider Demographics
NPI:1982185500
Name:HENION, JILL DENISE (MMFT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:DENISE
Last Name:HENION
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:DENISE
Other - Last Name:BEAULIEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17336 SE 82ND DR
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9516
Mailing Address - Country:US
Mailing Address - Phone:503-387-9674
Mailing Address - Fax:
Practice Address - Street 1:880 82ND DR
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-1803
Practice Address - Country:US
Practice Address - Phone:503-659-5515
Practice Address - Fax:503-233-2694
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist